Shoulder Fracture Surgery
The shoulder is the most flexible joint in the body, enabling a wide range of movements. It is a ball-and-socket joint made up of three bones, namely the humerus, scapula and clavicle. The head of the humerus (upper arm bone) articulates with the socket of the scapula (shoulder blade) called the glenoid cavity. The clavicle bone or collarbone is an S-shaped bone that connects the scapula to the sternum or breastbone. It forms two joints: the acromioclavicular joint, where it articulates with the acromion process of the scapula, and the sternoclavicular joint, where it articulates with the sternum or breast bone. Tendons and ligaments around the shoulder joint provide strength and stability to the joint.
What is a Shoulder Fracture?
A break in a bone that makes up the shoulder joint is called a shoulder fracture.
Types of Fractures
The clavicle and end of the humerus closest to the shoulder are the bones that usually get fractured. The scapula on the other hand is not easily fractured because of its protective cover by the surrounding muscles and chest tissue.
Shoulder Fracture Treatment
The treatment for a shoulder fracture is based on the type of fracture. Treatment can include non-surgical and surgical methods.
Your doctor may recommend surgical repair when:
- Broken ends of the bone are displaced
- Bone has broken through the skin (open fracture)
- Multiple fractures are present
- Injury to associated blood vessels or nerves
- Non-union or malunion of bones
However, surgery is contraindicated in:
- Older people with a sedentary lifestyle
- Presence of infection at the operation site
- Prior irradiation of soft tissues at operation site
- Burns over the fracture
Shoulder Fracture Surgery Procedure
Shoulder fracture repair is performed under general anesthesia. Your surgeon makes an incision in line with or perpendicular to the broken bone. The fat and muscles layers are carefully separated to expose the fractured region. The fractured bone is carefully positioned back to its normal alignment. A metal plate is positioned along the reduced bone and held in place with tacks or clamps. Screws are drilled into the bone through holes present in the plate. Pins may also be inserted to stabilize the bone while it heals. While the plates and screws are permanently placed, pins may be removed once the fracture has healed. Your surgeon will use fluoroscopy (live X-ray) to ensure that the screws and pins are placed in the right position and the underlying tissue is not harmed. Once the plate and screws are placed, the overlying tissue and incision is sutured and a dressing applied.
Postoperative Care following Shoulder Fracture Surgery
Following surgery, you may experience numbness just below the incision, which will recover with time.
You will be given physical therapy to assist with regaining function of the shoulder. Therapy will first involve gentle motion exercises. As your fracture heals, your doctor will gradually include strengthening exercises that will help restore movement in your shoulder.
You will be able to resume regular activities after about 3 months. Your doctor will be able to advise you when your shoulder has completely healed. You should avoid strenuous activities and lifting heavy weights before that time. After complete healing, you will be able to safely return to sports activities.
Risks and Complications of Shoulder Fracture Surgery
As with all surgical procedures, shoulder fracture repair may be associated with some of the following risks and complications:
- Blood clots in the leg
- Lung injury
- Need for revision surgery or hardware removal
- Injury to neighboring nerves and blood vessels